Return to Play to Pre-Injury Level Following Anterior Cruciate Ligament Injury.

The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria (AUC) for the Return to Play to Pre-Injury Level Following Anterior Cruciate Ligament (ACL) Injury . Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to determine the appropriateness of return to play to pre-injury level after an ACL injury. The AUC for the Return to Play to Pre-Injury Level Following ACL Injury were derived by identifying clinical indications typical of patients wishing to return to play after an ACL injury.

Autograft Versus Allograft in Posterolateral Corner Reconstruction: A Systematic Review and Meta-analysis.

Background: Several approaches to surgical techniques and graft types exist in posterolateral corner (PLC) reconstruction. The literature lacks knowledge regarding outcomes after autograft versus allograft reconstruction for PLC injuries.

Purpose: To comprehensively review the current literature on PLC reconstruction and compare outcomes between autograft and allograft tissues.

Posterior Cruciate Ligament Reconstruction With Quadriceps Tendon-Patellar Bone Autograft.

Multiple surgical techniques for posterior cruciate ligament reconstruction have been described and subsequently scrutinized. We describe a surgical technique using full-thickness quadriceps tendon-patellar bone autograft in single-bundle, all-inside posterior cruciate ligament reconstruction that offers the following advantages over traditional technique: This technique mitigates the risk of tunnel widening and convergence while preserving bone stock, eliminating the killer turn, allowing for suspensory cortical fixation to optimize stabilization, and using a bone plug that allows for faster graft incorporation.

Open Versus Arthroscopic Surgical Management for Recalcitrant Trochanteric Bursitis: A Systematic Review.

Background: While excision of the trochanteric bursae to treat lateral hip pain has increased in popularity, no comparison exists between the surgical outcomes and complications of the open and arthroscopic techniques involving trochanteric bursectomy. The purpose of this study was to determine the efficacies and complication rates of arthroscopic and open techniques for procedures involving trochanteric bursectomy.

Methods: The terms "trochanteric," "bursectomy," "arthroscopic," "open," "outcomes," and "hip" were searched in five electronic databases.

Anterior Cruciate Ligament Reconstruction with Quadriceps Tendon-Patellar Bone Autograft and Dual Tibial Fixation.

Anterior cruciate ligament ruptures are a relatively common injury in the athletic population, and surgical reconstruction is often indicated to restore knee stability. While hamstring tendon and patellar bone-tendon-bone autografts are a well-established graft choice in this population, there has been a growing body of literature supporting the benefits of quadriceps tendon autograft. Our technique illustrates a full-thickness quadriceps tendon-patellar bone autograft with dual tibial fixation using an interference screw and backup suspensory anchor fixation.

Factors associated with high pain catastrophizing in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome.

The purpose of this study was to determine if physical, mental health and patient-specific factors are associated with increased Pain Catastrophizing in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Patients who underwent primary hip arthroscopy for FAIS were retrospectively analyzed. Patients were included if they completed a standard pre-operative questionnaire which included the Pain Catastrophizing Scale (PCS), VAS and 12-Item Short Form Survey (SF-12) Physical and Mental Composite Scores.

Hip Arthroscopy for Femoroacetabular Impingement in Adolescents: 10-Year Patient-Reported Outcomes.

Background: Previous studies have demonstrated hip arthroscopy to be an effective treatment for femoroacetabular impingement (FAI) in individuals 18 years of age and older. Long-term outcome data in the adolescent population, however, are limited.

Purpose: To report 10-year outcomes after hip arthroscopy in adolescents with symptomatic FAI.

Patient-specific factors are associated with severity of chondrolabral injury in patients with femoroacetabular impingement.

Purpose: The purpose of this study was to evaluate the relationship between patient-specific factors, preoperative radiographic findings, and the presence and severity of chondrolabral damage identified during hip arthroscopy for femoroacetabular impingement.

Methods: Between 2014 and 2017, patients who underwent hip arthroscopy for FAI and labral tear were retrospectively reviewed. Patient-specific variables including age, gender, BMI, LCEA, and alpha angle were collected.

Para-acetabular Radiopaque Densities in Patients With Femoroacetabular Impingement: A Retrospective Assessment of Prevalence and Characteristics.

Background: Femoroacetabular impingement (FAI) syndrome is a common source of hip pain associated with chondrolabral injury. There is a subset of patients with FAI syndrome who present with radiopaque densities (RODs) adjacent to the acetabular rim.

Purpose: To evaluate the prevalence, characteristics, and patient-specific factors associated with RODs adjacent to the acetabulum in patients treated with hip arthroscopy for symptomatic FAI.

The Learning Curve in Hip Arthroscopy: Effect on Surgical Times in a Single-Surgeon Cohort.

Purpose: To quantify the effect of the learning curve in performing hip arthroscopy for femoroacetabular impingement (FAI) and labral tears on total operating room time, including times for setup, surgery, and wake up, during a single surgeon's initial hip arthroscopy procedures.

Methods: A single surgeon's case list was retrospectively reviewed to identify all primary hip arthroscopy surgeries between November 1, 2018, and February 28, 2018, for the treatment of FAI and labral tears. Surgical times were recorded, including total room time; surgical time; setup time; and wake-up time.

Postoperative Pain Management Strategies in Hip Arthroscopy.

Purpose Of Review: Hip arthroscopy is a rapidly growing field due to its significant diagnostic and therapeutic value in the management of numerous hip disorders. Adequate control of postoperative pain in patients undergoing hip arthroscopy continues to be a challenging and evolving area in orthopedics. In the absence of standardized protocols for pain management in these patients, a variety of different approaches have been utilized in an effort to find a regimen that is effective at reducing postoperative pain, narcotic consumption, and cost to the patient and healthcare system.

Outcomes After Arthroscopic Hip Labral Reconstruction: A Systematic Review and Meta-analysis.

Background: The acetabular labrum is critical to maintenance of hip stability and has been found to play a key role in preservation of the hip fluid seal. For irreparable labral damage, arthroscopic labral reconstruction is an evolving technique that has been shown to decrease hip pain and restore function.

Purpose: To provide a comprehensive review of current literature for arthroscopic hip labral reconstruction, with a focus on determining if outcomes differ between autograft or allograft tissue.

Surgeon Agreement on the Presence of Pathologic Anterior Instability on Shoulder Imaging Studies.

Background: In the setting of anterior shoulder instability, it is important to assess the reliability of orthopaedic surgeons to diagnose pathologic characteristics on the 2 most common imaging modalities used in clinical practice: standard plain radiographs and magnetic resonance imaging (MRI).

Purpose: To assess the intra- and interrater reliability of diagnosing pathologic characteristics associated with anterior shoulder instability using standard plain radiographs and MRI.

Study Design: Cohort study (diagnosis); Level of evidence, 3.

Brachial distal biceps injuries.

Distal biceps injuries are a relatively uncommon clinical condition that typically affect middle-aged males. They commonly occur due to an eccentric overload as the arm is forced from a flexed to extended position. Patients may experience an acute 'pop' and present with arm pain, swelling, and ecchymosis.

Gluteus medius tears of the hip: a comprehensive approach.

Greater trochanteric pain syndrome (GTPS) is a common clinical condition that can affect a wide range of patients. Historically, the condition has been associated with trochanteric bursitis. More recently, however, a growing body of literature has demonstrated gluteus medius tendinopathy and tearing is present in many cases of GTPS.

Bilateral Chronic Exertional Compartment Syndrome of the Leg: A Rare but often Debilitating Condition in Athletes.

This report discusses an unusual case of bilateral chronic exertional compartment syndrome (CECS) of the lower leg, a syndrome found mainly in young athletes. Pathophysiology includes exercise-induced muscle expansion against noncompliant fibro-osseous membranes separating compartments of the lower leg. A 24-year-old female distance runner with a history significant for misdiagnosed shin splints and tibial stress fracture presented with acute-on-chronic right lower leg pain.

Avulsion of the Anterior Lateral Meniscal Root Secondary to Tibial Eminence Fracture.

The lateral tibial eminence shares a close relationship with the anterior root of the lateral meniscus. Limited studies have reported traumatic injury to the anterior meniscal roots in the setting of tibial eminence fractures, and reported rates of occurrence of concomitant meniscal and chondral injuries vary widely. The purpose of this article is to describe the case of a 28-year-old woman who had a complete avulsion of the anterolateral meniscal root caused by a tibial eminence fracture with resultant malunion and root displacement.

Immediate physical therapy without postoperative restrictions following open subpectoral biceps tenodesis: low failure rates and improved outcomes at a minimum 2-year follow-up.

Hypothesis: We aimed to determine patient-reported outcomes in patients undergoing open subpectoral biceps tenodesis with a dual-fixation construct who had no postoperative range-of-motion or weight-bearing restrictions. Our hypothesis was that patients without postoperative restrictions would have low failure rates with improved patient-reported outcomes. We further hypothesized that this technique would allow an earlier return to activity and similar functional outcomes when compared with those reported in the literature.

Femoroacetabular impingement: a common cause of hip pain.

Femoroacetabular impingement (FAI) is a common cause of hip pain that can affect a wide range of patients. It is due to altered bony morphology of the proximal femur and acetabulum, resulting in decreased function and progression to early osteoarthritis. Until the early 2000s, little was known or understood about the significance of FAI as a clinical entity.

Survivorship and Outcomes 10 Years Following Hip Arthroscopy for Femoroacetabular Impingement: Labral Debridement Compared with Labral Repair.

Background: Studies have demonstrated hip arthroscopy to be an effective treatment for femoroacetabular impingement (FAI) with associated labral tears. The purposes of this study were to report 10-year outcomes and hip survival following hip arthroscopy for FAI and to compare labral debridement with labral repair.

Methods: Prospectively collected data on patients followed for a minimum of 10 years after hip arthroscopy for FAI with either labral debridement or labral repair performed by a single surgeon were retrospectively analyzed.

Femoroacetabular Impingement in Professional Football Players: Return to Play and Predictors of Career Length After Hip Arthroscopy.

Background: Previous studies have shown hip arthroscopy to be a highly effective treatment for symptomatic femoroacetabular impingement (FAI) in a wide range of athletes; however, the rate of return to play and length of career after hip arthroscopy in professional football players are unknown.

Purpose: To determine how many athletes returned to professional football and the number of seasons they played after surgery.

Study Design: Case series; Level of evidence, 4.

Arthroscopic Acromioclavicular Joint Reconstruction Using Knotless Coracoclavicular Fixation and Soft-Tissue Anatomic Coracoclavicular Ligament Reconstruction.

Acromioclavicular joint injuries are one of the most common shoulder injuries, and there are a variety of treatment options. Recently, there have been newer arthroscopic techniques that have addressed coracoid and clavicle fracture risk by using a knotted suture-button fixation through a single, small bone tunnel with additional looped soft-tissue graft stabilization. Although clinical outcomes have been good to excellent, there have still been instances of knot and hardware irritation.

Endoscopic Trochanteric Bursectomy and Iliotibial Band Release for Persistent Trochanteric Bursitis.

Lateral hip pain associated with trochanteric bursitis is a common orthopedic condition, and can be debilitating in chronic or recalcitrant situations. Conservative management is the most common initial treatment and often results in resolution of symptoms and improved patient outcomes. These modalities include rest, activity modification, physical therapy, anti-inflammatory medication, or corticosteroid injections.

Anterior Horn Meniscal Repair Using an Outside-In Suture Technique.

The menisci are important structures within the knee that play a critical role in maintaining proper stability, load distribution, and joint lubrication. Injury to the menisci has been found to significantly alter the complex biomechanics of the knee, and thus affect the health and longevity of the native joint. Tears involving the anterior horn are increasingly recognized as an important pathology.

Arthroscopic Treatment of Snapping Scapula Syndrome: Outcomes at Minimum of 2 Years.

Purpose: To investigate clinical outcomes after primary and revision arthroscopic treatment for snapping scapula syndrome (SSS) and identify predictive factors associated with outcomes.

Methods: Patients who underwent arthroscopic treatment for SSS between October 2005 and December 2013 were identified in a prospectively collected database. The inclusion criteria were patients with a diagnosis of symptomatic SSS, in whom extensive nonoperative modalities failed, who underwent arthroscopic surgery for SSS, and who had undergone surgery a minimum of 2 years earlier.